title: Bisphosphonates for osteoporosis in nonmetastatic prostate cancer patients receiving androgen-deprivation therapy: a systematic review and meta-analysis.
abstract: This systematic review was conducted to assess the efficacy and safety of bisphosphonates for prevention and treatment of osteopenia or osteoporosis in men with non-metastatic prostate cancer receiving androgen- deprivation therapy. We searched for randomised controlled trials (RCTs) of bisphosphonates compared with placebo from Pubmed, Embase, the Cochrane Library, and ISI - Science Citation Index. Meta-analyses of pre- specified outcomes (bone mineral density, fractures, and adverse events) were performed using Review Manager. Ten RCTs with a total patient population of 1,017 were identified. There was generally more improvement in bone mineral density of the lumbar spine for patients who received bisphosphonate treatment than placebo or other medical treatment at 12 months (WMD 6.02,95%CI 5.39 to 6.65). Similar effects were also observed for total hip, trochanter or femoral neck bone mineral density. However, there was no significant reduction in fractures. Fever and gastrointestinal symptoms were the most common adverse events (10.4% vs. 1.2%; 0.10% vs. 0.03%). Currently, our meta-analysis suggested that oral and intravenous bisphosphonates caused a rapid increase in spine and hip or femoral BMD in non-metastatic prostate cancer patients receiving androgen-deprivation therapy. Fever and gastrointestinal symptoms were common with the use of bisphosphonates. These short-term trials (maximum of 12 months) did not show fracture reduction. In future, more efficient performance of higher quality, more rigorous, large sample, long-term randomised controlled trials (>12 months) are needed where outcomes are detailed.
authors.affiliation: Institute of Urology, Key Laboratory of Diseases of Urological System Gansu Province, Gansu Nephro-Urological Clinical Center, Lanzhou, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Ding
authors.forename: Li
authors.initials: L
authors.lastname: Yang
authors.forename: Wan
authors.initials: W
authors.lastname: Du
authors.forename: Yang
authors.initials: Y
authors.lastname: Teng
authors.forename: Sheng-Jun
authors.initials: SJ
authors.lastname: Fu
authors.forename: Yan
authors.initials: Y
authors.lastname: Tao
authors.forename: Jian-Zhong
authors.initials: JZ
authors.lastname: Lu
authors.forename: Zhi-Ping
authors.initials: ZP
authors.lastname: Wang
mesh_terms: D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use; D015519:Bone Density / Q000187:drug effects*; D050071:Bone Density Conservation Agents / Q000009:adverse effects / Q000627:therapeutic use; D001851:Bone Diseases, Metabolic / Q000188:drug therapy* / Q000517:prevention & control; D004164:Diphosphonates / Q000009:adverse effects* / Q000627:therapeutic use*; D005269:Femur / Q000502:physiology; D050723:Fractures, Bone / Q000453:epidemiology / Q000473:pathology; D006615:Hip / Q000502:physiology; D006801:Humans; D008159:Lumbar Vertebrae / Q000502:physiology; D008297:Male; D010024:Osteoporosis / Q000188:drug therapy* / Q000517:prevention & control; D011471:Prostatic Neoplasms / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D000726:Androgen Antagonists; D050071:Bone Density Conservation Agents; D004164:Diphosphonates